Article Summary and Response on American’s Attitude towards Covid-19

How do most people feel when their loved ones leave them? It is not easy to take some occurrences such as death, and it takes time to accept that a family member has passed away. Currently, the COVID 19 pandemic is an excellent threat to the universe as it has reclaimed many lives and left many in tears.  Surprisingly some of the people in the United States of America have not shown an excellent reaction to the virus as many have shown to be in a celebrating mood, and life to them seems to be normal  (William Wan). Perhaps, the problem of insecurity is now stated to be homegrown, which means the problem lies in us. Attacks are planned and organized by people within the borders, making it difficult to control the problem, which means some people care less about the situation.  Besides, as William Wan and Brittany Shammas reporters for the Washington Post implies when explaining the state of Coronavirus in the United States and its unnoticeable effects, the Americans seem to care less about death caused by the virus, and this can be elaborated by focusing on the aspect of cultivating empathy in the age of pandemic and even in future.

According to Wan and Shammas in the article “why Americans are numb to the staggering coronavirus death toll,” it is evident that deaths caused by COVID 19 pandemic has not been exposed directly to the public and even to family members. People have been witnessed going on with their normal activities despite the increased number of deaths due to the pandemic, while the nurses in the health facilities are most touched by the high numbers of deaths every hour. According to the nurses, if the public could directly be exposed to Coronavirus's deaths, it could be easier for them to change their mindset towards taking the right actions to curb the situation (William Wan). People tend to reduce their apathy on mass deaths and suffering due to their hopelessness over the situation. The pandemic has not captured the Americans' attention as it has been with many other disasters; for instance, the Katrina hits led to hurried national attention. America's health system is experiencing a challenge as the people fail to take adequate preventive measures to curb the virus (William Wan). The deaths of the patients of COVID-19 are up close as the health practitioners also fear getting infected, thus leading to less care of the victims who die of loneliness and stigmatization. Although Americans have been witnessing their relatives' deaths, their response in terms of the level of apathy profoundly depends on the victim's demography. This leaves the elderly becoming more vulnerable to the virus, with statistics showing a more significant percentage of their loss of lives, unlike other age groups. However, the creation of Twitter accounts to share the pictures of the people lost due to the pandemic and acknowledging their deaths through the placing of seats near the White House are some of the ways used to cultivate apathy by Americans. Perhaps, imagining oneself in other people's roles is one of the best moves to control the spread of Covid-19.

It is beyond imagination to see Americans minding less about the effects caused by Covid-19.  I have been deeply shocked by citizens' overall behavior of failing to recognize the dangers caused by the pandemic bearing in mind that it is not normal to see people dying every day out of something we can control, but we end up being careless. During the Great Depression, the worsening of the economy was associated with a carelessness that led to the entire economy crashing. I solemnly agree with the authors’ point of view about the deep state of falling to accept that Covid-19 has negative impacts just because the increasing death toll is making us more substantial, and instead of taking this as a bad moment, we still maintain our regular activities. The feeling of vulnerability to the virus is not within us since the pandemic has become part of us, and for this reason, death is normal. The aging population seems to be the most affected by this carelessness aspect since they are the most vulnerable group to the virus's severity (William Wan). I have less imagined what the world will be like without feelings for one another, taking; for instance, losing family members out of something that I can control is more of a betrayal. The doctors in health facilities have witnessed it, but people do not care about the pandemic anymore; it is devastating to see patients die without anyone’s attention, not even a family member. Besides, the increased deaths due to Covid-19 have a lot to do with a lack of empathy for others, with people even taking no caution.

In my opinion, the empathy deficit among Americans is increasing as witnessed by celebrating mood despite the death records, which grew every hour. Louisiana floods left many of the residents homeless and recognized as the country's largest disaster for one hundred years. This was due to heavy rains for some weeks, and around 12000 people were forced to leave their homes. Volunteer groups were observed helping with some hygiene kits and giving other resources to the homeless people. There was an excellent response to help people who were left homeless, and this showed great empathy. The Coronavirus pandemic has not been responded to well by many Americans as some interact as if life is every day, despite the pandemic which has reclaimed thousands of lives (William Wan). I believe that most of Americans' reactions were due to helplessness as there is nothing they could do about it to end the pandemic. Besides, the medics were left with a tremendous role in caring for the victims who have the obligation of showing empathy to them. It is essential to show our emotions to the victims by behaving in a way that shows the sense of danger and acting to limit the spreading of the disease, and this is by taking control measures provided by the state thoughtfully.

The future of the current Covid-19 situation directly depends on everyone's response to the disease. More emphasis needed to be paid to the reality of life by creating an intense awareness concerning the virus's severity. Perhaps, just like the way the people in connection to state authority have joined hands in responding to other deadly disasters that have happened before, it is now high time to cultivate the sense of feeling for one another in the name of winning the fight together. Developing empathy, by all means, will give concrete meaning to life, and this can only be cultivated by understanding the need to take responsibility and take caution in the face of any deadly disaster.

Works cited

William Wan, Brittany Shammas. "Why Americans Are Numb To The Staggering Coronavirus Death Toll". MSN, 2021, https://www.msn.com/en-us/news/us/why-americans-are-numb-to-the-staggering-coronavirus-death-toll/ar-BB1c78Pd.

Increased Pressure Ulcers in ICU

Clinical problem

 The problem identified is increased pressure ulcers in ICU. Pressure ulcers are encountered among the most vulnerable and weak members of the community. This issue causes patients and their relatives torment, uneasiness, and financial constraints due to the pricey medications (Boyko, Longaker, & Yang, 2018). Medical reports reveal pressure ulcers within the ICU may hinder the delivery of proper medication in the long run.

Research Gaps

 Increased pressure ulcers are increasing each day. The underlying causes of the increasing ulcers in ICU is not yet defined in medical systems. Also, the execution and management of evidence-based mechanisms are not yet defined to give accurate results whenever patients suffer from increased pressure ulcers (Boyko, Longaker, & Yang, 2018). Thus, the lack of proper definite ways of tackling the issue seems to hinder proper research into reducing the increasing pressure ulcers among the vulnerable and weak.

Variables Needed To Fill the Gap

 One of the ways of reducing increased pressure ulcers is by ensuring skilled medics implement programs that will facilitate and initiate investigative measures whenever pressure ulcers occur in ICU. This way, they will be able to define the parameters which are responsible for the pressure ulcers (Agrawal & Chauhan, 2012). Secondly, the conditions of the ICU at the time of the occurrence needs to be considered so that the medics can work on improving the contextual conditioning of the room. All the risk factors that are normally responsible for causing the condition are to be researched further and looked into more keenly so that the medics can know how to tackle the issue more soberly and with a background full of evidence. More so, being able to isolate patients who are more likely to experience increased pressure will make it easier for medical experts to deal with it on a timely basis.

Reference

Agrawal, K., & Chauhan, N. (2012). Pressure ulcers: Back to the basics. Indian journal of plastic surgery: official publication of the Association of Plastic Surgeons of India, 45(2), 244.

Boyko, T. V., Longaker, M. T., & Yang, G. P. (2018). Review of the current management of pressure ulcers. Advances in wound care, 7(2), 57-67.

Genitourinary System

Introduction

Most patients suffer from numerous genitourinary system illnesses. The genitourinary system is made up of the kidney, ureter, and other genital body parts. From fetus development to adulthood, the genitourinary system is exposed to various potential sources of injury. People might contact illnesses or conditions which destroy genitourinary organs. However, with age, numerous changes occur to the genitourinary systems. Regular aging impacts the upper and lower urinary region. Lower alterations comprise decreased bladder size and urethra acquiescence, increased detrusor contraction among others.

Genitourinary System Normal Aging Process

 Aging causes variations in the kidney and bladder. The function of the kidney is filtering blood which in turn eradicates toxins from the human body. Also, the kidney assists to regulate the body's chemical equilibrium. The kidney makes up the urinary system. The urinary system is made up of the ureter, bladder, and urethra. Muscular alterations and variations within the reproductive organs have the potential of affecting bladder regulation. Aging is a primary factor because it impacts kidneys and bladders (Barth et al., 2020). At one age, the kidney and bladder are subject to modification. Hence, the functionality is compromised in the long run. Within the kidneys, tissue size decreases hence the filter spaces decrease. Filter systems are made up of nephrons that filter toxins from the body. Blood vessels connecting the kidneys gradually harden hence leading to kidneys function at a slower rate. In terms of bladder alterations, the changeable tissue wears out into a hardened and less flexible tissue. Therefore, the bladder’s retention capacity decreases due to the decreased elasticity. Also, the bladder loses its muscular tendencies. Also, the urethra decreases in size which leads to blockage.  In females, weakened muscles cause vaginas and bladder to tear down while in men, the engorged prostate gland blocks the urethra. In normal aging, individual kidney functionality is not altered. However, diseases and other situations can negatively impact the kidney's role in the body.

Aging intensifies the kidney and bladder challenges. For instance, the bladder regulates matters such as seepage. Seepage is failing to retain urine in the bladder for a long time. Also if a person fails to fully empty the bladder, it is a challenge that can be traced to aging muscles of the urinary systems (Saran et al., 2017). Thus, the changes affect the functionality and muscle strength of the bladder and kidneys.

 Some of the alterations that result from kidney aging are condensing within Bowman's capsule and decreased penetrability, degenerative alterations within the blood vessels, and reduced nephrons and blood vascular alterations at the vascular systems. Renal effectiveness can be dysfunctional whenever people age due to the reduced nephrons as one advance in age.  Also, it is important to note that blood within the renal decreases as one reaches the advanced age of 75 years old. In terms of Glomerular percolation frequency, the excretory size decreases as one age. As the kidney ages, it can sustain regular homeostatic functions such as eradication of waste material from the body (Traish et al., 2018).  However, these functions are done at a slower rate and with less efficiency than before due to the reduced number of reserves needed for filtration. Similarly, due to the reduced efficiency, reduced chances of dehydration, contamination, and damage of the kidney is one of the highlights that marks normal genitourinary system aging.

 In the prostate region, atrophy is the first sign of normal aging of hyperplasia regions. Benign hyperplasia manifests in most men who attain 80 years of age. More so, histological matters are said to be more common due to the impact of aging mechanisms on genitourinary systems (Xiao et al., 2017). Kidneys’ function is the filtration of blood and also assists to eradicate wastes and additional liquid from the body. In terms of regulation, the kidneys ensure that a human body's chemical balance is at equilibrium. Hence, being one of the most outstanding and vital organs, the kidneys form part of the urinary system. Muscular alterations are part and parcel of the changes that are experienced due to normal aging of the genitourinary system (Özcan et al., 2018). Aging affects the regulation of the bladder hence it becomes hard to control urine flow. With aging comes alteration which then affects the functionality of the entire genitourinary system. Kidney tends to decrease in size due to the degeneration of its tissues. Also, nephrons are minimized hence the removal of toxins from the body reduces. Besides, time changes biological mechanisms within the genitourinary system. Aging is known to be gradual and systematic hence changes that come about aging are known and predictable. The process of aging heterogeneous hence organs age differently and at different rates due to underlying factors such as genetic material and lifestyle. First, the physiological structures and functions are complete changes due to her gradual and steady process of aging. Age affects temperature and even the hormone cortisol which is in plenty in the genitourinary system.

 The specific differences in the gerontology population of the genitourinary system

 People aged 65 years and above are increasing in number all over the world. Also, researchers revealed data that shows more people are diagnosed with genitourinary system failure due to advancement in age. Histological alterations within the kidney seem to be the main cause of this genitourinary system diagnosis. Contemporary researches have unveiled that as one age kidney experiences various structural alterations which in turn alter its functional behaviors. These changes weaken the kidney's capability to resist damage and reconstruct after an injury. Due to the reduced functionalities, most people are prone to diseases associated with the kidneys due to the putative manner in which pathways are destroyed ad hindered from performing basic functions (Woodhouse, 2019). Even though normal aging has no impact on homeostatic liquids, renal reserves among old individuals might reduce. Longitudinal modifications and urinary tract systems tend to be more strained with time hence old people are at a higher risk of acquiring illnesses related to the genitourinary system. Thus, it is well known that all over the world, the population is aging at a fast rate which in turn has increased the number of diseases that come with an aging genitourinary system. in the name of coming up with more than one way of assessing the number of people with severe genitourinary system illness, experts have concluded that sometimes aging is more damaging due to the lifestyles people live or adapt. Advancement in age leads to a decline in the number of nephrons hence tubular changes take place in the kidney as the membranous walls thicken thus increasing glomerulus sites. More than 10% of people aged 10 years and above might suffer from nephrosclerosis and hypertension due to the blockage that occurs as one advance in terms of age.

Genitourinary System Diseases

 Most of the illnesses or conditions result from aging.  One of the conditions that result from the gradual aging of the genitourinary system is urinary incontinence. Urinary incontinence is much more common in terms of regular occurrence due aging process which impedes its functionalities. Based on medical records, urinary incontinence is estimated to be 15-35% among the old generation. In the USA most of the people aged 60 years and above are susceptible to acquire urinary incontinence. The general occurrence rate of this condition increases with age amongst both males and females. Most of the contemporary surveys reveal that 21.8% of the people aged 85 and 90 years old suffer from this condition (Althumairi, & Efron, 2016). Urinary incontinence negatively affects the self-esteem of a person hence linked to the increasing number of depressed people. Therefore, incontinence impacts the social component of one's life as it minimizes the number of activities one can do at a go. Also, it forces one to depend on caregivers and guardians. Most of the people who have this condition are old people and they tend to stay at home so that they cannot be an embarrassment to the rest of society. There are various kinds of urinary incontinence but they all cause involuntary urine loss. Hence, urinary incontinence can be said to be chronic or acute depending on its severity.

 Another genitourinary system that is common among the elderly is urinary tract contamination which is normally caused when a bacteria affects some parts of the genitourinary systems. Even though data reveals that the disease needs to be handled with antibiotics, there are chances that it might occur once again due to the bacteria causing it. Also, urinary tract infections can negatively impact any part of the genitourinary system such as the kidney and bladder. The majority of the infections attack the lower sections of the urinary region- bladder and urethra. Females are more prone to acquire this disease than their counterpart males are. The infection only spreads around the bladder (Zhou et al., 2020). Nevertheless, severe consequences could cause the disease to spread to kidney regions.  Some of the symptoms connected to urinary tract infection is a persistent urge to urinate and inflammation whenever urinating. Among the elderly, this disease occurs due to the increasing number of bacteria responsible for causing the disease and other factors such as temperature. Currently, there is no research to account for the constituents making up the bacteria causing urinary tract infection. One of the main risk factors is aging due to the catheterization of the entire based system which in turn gives room to the growth of the bacteria.

Nursing Interventions

 The nurses or medics usually come up with medical plans to prevent and even mitigate the challenges that come with suffering from genitourinary infections. For instance, urinary tract infection is normally caused by a bacterium found within the urinary system. One of the most common ways of coming to terms with the ancient ways of preventing this disease is to kill the bacterium responsible for the disease in advance (Özcan et al., 2018). Also, the bacterium can be caused whenever the patient immune system weakens hence allows the bacterium to grow in the body. Using antibiotics only means that this disease differs in severity. Due to the sensitivity of the illness, one has to take into account the level of spread and then act on it based on the intended rate of infection.

 In urinary incontinence, there are behavioral interventions that can be put in place to prevent a person from developing the disease. A chance to come to terms with bladder training gives a person a chance to urinate normally. Bladder training is supposed to last for about ten minutes (Saran et al., 2017). Daily training of the bladder strengthens the muscular tissues and makes them stronger hence one can regulate his urine. Another tactic that can be used to regulate the bladder is through a mechanism known as double voiding where a person empties their bladder. Double voiding implies that one urinates two times in a row to ensure that the bladder is empty. Also, the genitourinary system has to be in line with the functionalities of other components. In the wake of coming to terms with more than one way of treating the condition, schedules toilet sprees so that a pattern can be developed and form a pattern of dealing with the issues around genitourinary systems.

In summary, the genitourinary system gradually weakens with time. Also, with time, it is exposed to infectious diseases and inflammations. Some of the alterations that come as a result of normal aging are caused due to muscular variations, tissue blockage, and loss of flexibility of blood vessels. For instance, within the kidney, the nephrons become less in number and decrease in size. The anatomy and structure of the genitourinary system decrease in functionality as the entire system is impeded with time. In most cases, people tend to acquire diseases such as urinary tract infection and urinary incontinence.

References

Barth, D. A., Juracek, J., Slaby, O., Pichler, M., & Calin, G. A. (2020). lncRNA and mechanisms of drug resistance in cancers of the genitourinary system. Cancers, 12(8), 2148.

Saran, R., Robinson, B., Abbott, K. C., Agodoa, L. Y., Albertus, P., Ayanian, J., ... & Shahinian, V. (2017). US renal data system 2016 annual data report: epidemiology of kidney disease in the United States. American journal of kidney diseases, 69(3), A7-A8.

Traish, A. M., Vignozzi, L., Simon, J. A., Goldstein, I., & Kim, N. N. (2018). Role of androgens in female genitourinary tissue structure and function: implications in the genitourinary syndrome of menopause. Sexual medicine reviews, 6(4), 558-571.

Xiao, X., Hu, R., Deng, F. M., Shen, S. S., Yang, X. J., & Wu, C. L. (2017). Practical applications of immunohistochemistry in the diagnosis of genitourinary tumors. Archives of pathology & laboratory medicine, 141(9), 1181-1194.

Özcan, H. Ç., Balat, Ö., Uğur, M. G., Sucu, S., Tepe, N. B., & Kazaz, T. G. (2018). Use of bladder filling to prevent urinary system complications in the management of placenta percreta: a randomized prospective study. Geburtshilfe und Frauenheilkunde, 78(2), 173.

Woodhouse, C. (2019). The effects of recreational drug use on the genitourinary tract. Trends in Urology & Men's Health, 10(4), 18-20.

Althumairi, A. A., & Efron, J. E. (2016). Genitourinary considerations in reoperative and complex colorectal surgery. Clinics in colon and rectal surgery, 29(2), 145.

Zhou, J., Yang, X., Zhou, L., Zhao, M., & Wang, C. (2020). Anastomosing Hemangioma Incidentally Found in Kidney or Adrenal Gland: Study of 10 Cases and Review of Literature. Urology Journal.

Sterilization and Decontamination

Case study 1: Decontamination Principles

Decontamination entails a blend of processes which includes cleaning, enhanced cleaning, and disinfection that are used to ensure that re-usable medical instruments are safe for re-use (Panta et al., 2019). With respect to the case study, it is evident that an issue of lack of proper decontamination has occurred. The cause of the error might include the lack of clear management control measures, in-experienced technicians, and the absence of guidelines to follow for the decontamination. Decontamination is a public health problem since when it is not effectively done it increases the risks of Hospital-acquired infections (HAI) (Panta et al., 2019). In this context, enhanced cleaning was omitted resulting in dirty surgical instruments, which poses a major health threat. Cleaning during the decontamination process can either be done manually or using automated machines. The efficiency of the cleaning process with regard to minimizing microbial contaminations usually depends on various factors such as the amount of dirt present and cleaning thoroughness (Forrester et al., 2018). Enhanced cleaning has proven to be successful in increasing the safety of medical instruments while also minimizing infections.

The sterile processing department can resolve the issue by setting new measures and management control for cleaning, sterilizing, and storing medical devices such as surgical instruments to ensure patient safety (Forrester et al., 2018). The department should not only be responsible for ensuring that the instruments are properly cleaned, processed, and stored but also creating awareness and familiarity among technicians. The best practice in the decontamination process should incorporate the equipment cleaning phase, enhanced cleaning, disinfection as the use of specialized automated machines (Panta et al., 2019). The four-way technique is the most successful in cleaning and decontaminating medical equipment hence protecting patients as well as healthcare professionals from infections spread. Setting clear guidelines and training technicians on proper decontamination can help in ensuring that clean medical instruments are delivered to the surgical suite.

Case Study 2: Sterilization Methods

Sterilized loads are normally considered as a wet load in the case that moisture comprising of droplets, dampness, or water puddles is present on the package even after the cooling period (Basu, 2017). Moisture on sterilized loads is caused by non-condensable gases (NCG) including nitrogen, oxygen, and carbon dioxide as they create wet packs (Basu, 2017). The issue might result from having an extensive duration between the cycles of sterilization and cooling or a defective vacuum pump which leads to air pockets building in the sterilizer compartment (Mohapatra, 2017). Also, it is worth noting that the presence of ineffective steam traps affects the ability to capture NCGs moving within the steam pipe.

Wet packs on sterilized loads can be prevented by the application of several methods such as the use of good steam quality, period maintenance and assessment of the autoclaves, avoid overloading the sterilizer, permitting substantial after sterilization period for the devices to cool down within room temperature, using high-quality wrapping supplies, proper temperature maintenance as well as humidity of the storage setting (Mohapatra, 2017). In this case, the problem can best be eliminated by ensuring that the equipment is of the highest quality equipment for sterilization to avoid steam from building up.

The wet load issue tends to result creates inefficiency issues for the sterile department while it threatens the safety of patients and healthcare staff in the operating room (Basu, 2017). The ability of the surgical team to provide quality and safe services to the patients is adversely affected, which intensifies the risks for spreading infections (Mohapatra, 2017). In ensuring quality control, Kristen should identify the loads and return them to be processed further by documenting them as unsterile devices.

References

Basu, D. (2017). Reason behind wet pack after steam sterilization and its consequences: An overview from Central Sterile Supply Department of a cancer center in eastern India. J Infect Public Health, 10(2), 235-239. https://doi.org/10.1016/j.jiph.2016.06.009

Forrester, J. A., Powell, B. L., Forrester, J. D., Fast, C., & Weiser, T. G. (2018). Surgical instrument reprocessing in resource-constrained countries: a scoping review of existing methods, policies, and barriers. Surgical Infections, 19(6), 593-602. DOI: 10.1089/sur.2018.078

Mohapatra S. (2017). Sterilization and Disinfection. Essentials of Neuroanesthesia, 929–944. https://doi.org/10.1016/B978-0-12-805299-0.00059-2

Panta, G., Richardson, A. K., Shaw, I. C., Chambers, S., & Coope, P. A. (2019). Effectiveness of steam sterilization of reusable medical devices in primary and secondary care public hospitals in Nepal and factors associated with ineffective sterilization: A nation-wide cross-sectional study. PloS one, 14(11), e0225595. https://doi.org/10.1371/journal.pone.0225595

Demands Placed On the NHS

1

Changes to Demands

Most of the changes were geared towards meeting the costs and increasing demands. Even though these alterations are taking place at a time when the budget is tight, the NHS has to respond positively to the changes to be effective and relevant to its functions. After the NHS was set up, the life expectancy skyrocketed for both males and females and this pattern may continue in the next decades (Pascoe, 2017). However, an aging population implies that the NHS will have to deal with a more severe condition such as dementia. Hence, at the end of the day, its functionality will be hindered due to less support and care. For example, medical reports claim that more than 65% of hospital beds are occupied by the elderly. In response to the rising population, NHS has resulted in providing home medication so that its case ease off hospital space. Where it meets more expenses, the medication is designed to meet the immediate needs of the patients. Increasing the number of medical consults outside medical institutions has catered to more people and reduced pressure in most hospitals. For example, setting up minor surgery clinics. Nurses have also taken up more roles in an attempt to decrease pressure and ease the burden placed on primary health care.

2

Changes in Funding and Its Impact on NHS

 During the Austerity period in the 2008 economic meltdown, the NHS budget persistently increased at a gradual rate. Also, the budget rose due to inflation elements. The government had to announce a five years funding plan which would cater to most of the primary NHS functions (Singfield, 2020). Also, NHS is as effective as the budget allocated to it. NHS can only perform operations within its financial needs (Pascoe, 2017). Recurrent expenditure and emergencies limit NHS from doing more than it could have done. Consequently, patients have to dig deeper into their pockets before getting quality medical care.

 In terms of the immediate impact of funding on NHS, finances are strained. In 2010, the economic constraints inhibited development and the ever-increasing demand resulted in challenging tasks and the inability to live within their capable means. In the recent past, some medical institutions got more financial support than others. However, current NHS organization mechanisms are geared toward changing the approach insisting on a balanced budget. Health care systems internationally must make decisions based on services and medical treatment rendered so that they can provide more openings for catering to the needs of the vast population of patients streaming into medical institutions. Therefore, all the medical bodies should be involved in the decisions which in the process changed the functionalities of the entire formulating body (Singfield, 2020). Medical officials, service providers, and specialists tie their decisions to national policies, medical directives, records, local preferences, and other supplementary needs emerging from the day to day operations. Due to these numerous ranking factors, it is challenging to look at each factor as being separate from another.

The chance of coming to terms with the changes has placed intense pressure on NHS. The pressures range from the holding capacity and the ability to comfortably adapt to the changes in the long run (Singfield, 2020). For example, the increasing demand for community increase led to increased substantiality costs because lack of substantial facilities might lead to unmet medical demands.

References

Pascoe, P. (2017). To improve change management, the NHS needs to discard outdated models. LSE Business Review.

Singfield, A. K. (2020). Transformational change in the NHS: using action research to improve the way change leadership skills are developed (Doctoral dissertation, Middlesex University).

 Audiology Professional Practice

Introduction

 Adrienne began experiencing hearing difficulties in her late 40s. Having lived with someone with hearing loss, Adrienne thought that she would have a better understanding of the medical condition because her mother had suffered from hearing loss. However, when it happened to her, she was a bit prepared to tackle the issues that came along with having the condition (Patient Insight Films, 2021, np). For instance, she bought hearing aids. At first, it was hard to adapt to her newfound reality but with time she got used to her situation. A hearing loss made life hard because she never knew if she could be singled out and discriminated against.

When her hearing deteriorated further, she sought medical advice from the National Health’s audiologist but she never got the help she needed. The audiologist who attended to her claimed that she would never hear music again. After the awful ordeal with the audiologist, she decided to seek private medical services. In the private sector, she got all the medical assistance she needed. Her specialist carried out more than 14 tests and ensured that she listened to the patient’s wants and medical needs. The specialists recommended that Adrienne should try using lip-reading glasses. Also during her private sessions, Adrienne joined a class where she met other people with the same hearing condition (Patient Insight Films, 2021, np). Thus, the private audiologist took an interest in the patient and ensured that she provided her every medical need.  According to Adrienne's experience, she at the National Health, her medical requirement was never met or even considered unlike in private session where her every need was considered and taken into account. Hence, the private session always kept in touch with Adrienne and monitored her progress closely as they took note of any deviances that might have emerged on the way. The private medical services allowed her to return to her social life hence giving her a second chance at life. Activities such as fingerspelling and lip-reading have given her more things to do while outside the house hence increasing her chances at coping with the hearing loss.

Person-Centered Care for People with Hearing Losses

 Person-centered care is attained through numerous strategies such as effective communication and mutual decision mechanisms. Hearing loss impedes one’s ability to make conscious decisions hence leading to societal isolation. The chance one gets to attend medical institutions needs to be followed up by coming to terms with the condition and the formulation of a medical plan (Santana et al., 2018, 429). Person-centered care should aim at addressing the impact of hearing loss on an individual and the most effective way of dealing with the issue that arises as a result of the manifestation of the hearing loss. The important role of person-centered care has been defined all over the world by administrations and even policymakers. Person-centered care facilitates the collaboration between medical care specialists, clients, and other third parties such as relatives (Wallström, and Ekman, 2018, 118). This collaboration allows clients to actively take part in their medical care and supports independent decision making. One of the most primary elements of person-centered care is the joint decision-making process which implies consultation mechanisms whose aim is informing the decision-making mechanisms while at the same time accounting for the values and personal preferences.  Joint decision making is made possible through pro-active ingenuities such as effective communication and support decision making.

Person-centered care is pertinent due especially among deaf patients and residential aged individuals. For instance, Adrienne felt neglected and abandoned as the system seemed like they never gave her enough attention. During one of Adrienne's visits, the audiologists claimed that she will never be able to listen to music again. This statement shuttered her dreams and hopes of ever recovering from hearing loss (Ulin, Olsson, Wolf, and Ekman, 2016, 19). However, the private sessions gave Adrienne the chance to come to terms with her condition and the underlying issues that she needed to deal with before she could be able to handle the intricacies that came as a result of the hearing loss. Whenever she inquired about her condition, during the private session (Haydon, Browne, and van der Riet, 2018, 125). One of the main aims of person centered care is solving a medical challenge based on the preferred treatment from the patient. In the meantime, people who prefer the use of person-centered care normally anticipate treatment based on personal needs (Moore et al., 2017, 662) Also, person-centered care is not limited to the amount of time one spends at a medical institution. For instance, in Adrienne’s situation, the specialist kept in touch with her even after she was dismissed from the medical institutions.

 At the center of patient-centered care is valuing the client's condition and opinion. For instance, Adrienne never felt appreciated and cared for. She claims that her needs were ignored as she was viewed just as a number. In other words, she never felt special and if she did not feel special, then it means that no one bothered to tailor her medical conditions to the needs of her condition (Bhattacharyya et al., 2019, 242). Secondly, her values were to be observed and not ignored as long as she was receiving her medical treatment. For instance, the first audiologist never seems to bother with the discouraging statement she made about Adrienne. However, the second one cared and ensured that she actively participated in her situation which in turn improved the patient's condition. in this particular case, when she went into more than one issue with the patient, one needs to always monitor the patient to meet the many needs that might emerge from the conversation or even indirect medication.

 The hearing loss occurrence increases with an increase in age as other factors. For the sake of bettering the quality care, one has to comprehend person centered care in terms of preference and other issues that might arise while the person is receiving treatment (Sjögren et al., 2017, 44). Person-centered care brings out a specific manner of thinking and carrying out medical services. The planning, development, and initiation of modern-day monitoring systems rely solely on the value systems meeting the needs of the patient. From the footage, one can tell that Adrienne's husband was well versed with her condition due to the partnership between the specialist and other family members.

 Person-centered care does not just mean giving details on a patient's status, but the ability to consider her needs, value, family context, communal needs, and even daily routines. Also, the medic has to perceive the patient as a person and creates a common friendship that would enable the building of trust between the patient and the specialist. Adrienne applauded the second audiologist for considering her needs and recommending activities that are aligned to her social needs (Hansson et al., 2016, 276). For the sake of coming to terms with a condition, specialists have to be compassionate and solve medical issues from the patient's perspective. In the meantime, one has to be more conversant with the patient and respectfully while sometimes informing the patient on a thing that needs to be done for the medication to be successful. One way of showing respect is deciding with the patient. A patient has a role to play in the decision-making process as his or her voice is incorporated into the entire medication. The patient should part and parcel of the entire medication and cater to the needs of the entire recovery process.

Adrienne felt that public medical institutions dealt with numerous people hence had no time to fulfill the needs of each patient. In the end, no patient was treated humanely and with the respect they deserved. Helping clients manage their medical condition is not limited to certain activities but the resultant bond that the clinician forms with the patient. A strong bond results in communication between the patient and the specialist. Once one has more than one aspect of medication, the best approach is person centered. In the recent past, people were to fit into rigid medical routines and operations (Naldemirci et al., 2018, 54). However, to make person-centered care services effective, the services are supposed to be tailored according to the needs of the patient and give more meaning to the entire medical service as provided by the specialists. Hearing loss can only be truly aligned to basic patient needs if the patient and the specialist make a joint decision to come up with defined ways of delivering medication. This might involve cooperating with patients' relatives, to settle in suitable ways of offering proper healthcare.

 Conclusion

            Adrienne was able to better cope with her condition due to her previous interaction with her mother’s hearing loss. The first audiologist who dealt with her situation was not interesting in her wellbeing because she claimed that she would never hear music again. However, the second specialist was a private service provider who stayed in touch with Adrienne. In no time Adrienne enrolled in a lip reading class where she found other people who had her condition. Person centered takes into consideration a person’s needs and values. Adrienne felt appreciated by the second specialist because of the concern and caring attitude she had toward her. Also, during her private clinical session Adrienne had plenty interactions.

References

Bhattacharyya, O., Blumenthal, D., Stoddard, R., Mansell, L., Mossman, K. and Schneider, E.C.,             2019. Redesigning care: adapting new improvement methods to achieve person-centred care. BMJ quality & safety, 28(3), pp.242-248.

Hansson, E., Ekman, I., Swedberg, K., Wolf, A., Dudas, K., Ehlers, L. and Olsson, L.E., 2016. Person-centred care for patients with chronic heart failure–a cost–utility analysis. European journal of cardiovascular nursing, 15(4), pp.276-284.

Haydon, G., Browne, G. and van der Riet, P., 2018. Narrative inquiry as a research methodology exploring person centred care in nursing. Collegian, 25(1), pp.125-129.

Ida Institute. 2021. Patient Insight Films. [online] Available at: <https://idainstitute.com/what_we_do/video_library/ethnographic_films/patient_insight_films/> [Accessed 4 January 2021].

Moore, L., Britten, N., Lydahl, D., Naldemirci, Ö., Elam, M. and Wolf, A., 2017. Barriers and facilitators to the implementation of person‐centred care in different healthcare contexts. Scandinavian journal of caring sciences, 31(4), pp.662-673.

Naldemirci, Ö., Lydahl, D., Britten, N., Elam, M., Moore, L. and Wolf, A., 2018. Tenacious assumptions of person-centred care? Exploring tensions and variations in practice. Health, 22(1), pp.54-71.

Santana, M.J., Manalili, K., Jolley, R.J., Zelinsky, S., Quan, H. and Lu, M., 2018. How to practice person‐centred care: A conceptual framework. Health Expectations, 21(2), pp.429-440.

Sjögren, K., Lindkvist, M., Sandman, P.O., Zingmark, K. and Edvardsson, D., 2017. Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study. BMC nursing, 16(1), p.44.

Ulin, K., Olsson, L.E., Wolf, A. and Ekman, I., 2016. Person-centred care–An approach that improves the discharge process. European Journal of Cardiovascular Nursing, 15(3), pp.e19-e26.

Wallström, S. and Ekman, I., 2018. Person-centred care in clinical assessment.

The Effects of Acculturation on Depression among Older Adult U.S. Immigrants

Introduction

With the advancement of medical technology, Americans are enjoying an extended life span. The growth of the older population has been significant over the past couple of years, which surprising. According to Cho (2019), while the population of the older population aged 65 years and above continues to grow in the U.S, it is expected in the next ten years, the country will mark a vital demographic turning point based on the current statistics. However, while the expanded life span is certainly a good thing, it has created its own set of challenges given that the older population remains highly vulnerable to chronic illness such as mental conditions where depression is the most common. Older people are more likely to suffer from depression because old age denies them the opportunity to participate in the day to day activities by taking away their independence due to morbidities. While it is only 20 percent of the older population in America that has been diagnosed with depression, most of them believe that depression is not a major health issue which indicates the level of denial. Also, depression is highly misdiagnosed due to the overlapping symptoms with other conditions and is the leading contributor to depression among older adults. Considering the vulnerable state of older adults, immigrants are more susceptible to depression as a result of the challenges associated with acculturation alongside other contributing factors like genetics, socio-economic status, gender, and family history. To treat depression successfully among older adults, cultural competence is an essential skill among social workers.

Thus the objective of this paper is to thoroughly examine the overall effects of acculturation on depression amongst older adult immigrants in the U.S. Thus, the research is an important part of social work since understanding the underlying cultural assimilation challenges can be vital in improving the quality of lives for all clients. The systemic review will be useful in gaining better-understanding acculturation factors that contribute to depression among older adults. Acculturation refers to the process of assimilating to the dominant culture which involves the change of behavior, values, attitudes as well as an identity which leads to the development of a new cultural belief. The acculturation process has widely been hypothesized across studies as stress and might adversely affect the mental health of individuals as it compels individuals to choose between two conflicting identities while trying to fit in a society that is aggressive to minorities. Acculturation has been established to intensify depression levels among older immigrants in the U.S. The report will begin by a review of existing literature to establish the overall implication of acculturation on depression among older U.S immigrants. This will be followed by a methodology section outlining the approaches to be used in data collection and analysis and a discussion of challenges and limitations associated with the current research.

Literature Review

Depression is one of the most common mental related illnesses that affect individuals of all ages. Cho (2019) posits that older adults are more susceptible to the condition as old age affects their ability to actively participate in the socio-economic setting as before. The loss of independence alongside social challenges contributes to the intensification of stress among older adults. Depression tends to negatively affect the way people feel, think, or behave in general. Older adults suffering from depression are from low socio-economic settings, and this implies that a significant number are from a minority group (Mao, Xu, Guo & Chi, 2018). The situation is because they lack the needed family and social support which further creates more challenges for them hindering their ability to navigate on a day to day basis. For this particular group access to basic needs and healthcare is limited or does not exist and this makes them more vulnerable.

According to Kim & Choi (2015), while most individuals immigrate to the U.S before the age of 65, the immigration process offers both challenges and opportunities. The challenges normally become more evident during old age as they have to contend with their cultural and social changes that are required to adapt to the new setting. It is apparent that while the American culture is more individualistic and modern most of the minority cultures hold rather conservative beliefs. There is a clear and visible mental health disparity among the majority and minority. While most studies have widely documented socio-economic factors and genetics as the leading contributor to the existing disparity, most have failed to acknowledge the effects of acculturation on the widening rate of depression among older adults’ immigrants in the U.S. 

Acculturation and Mental Health among Older Adults

Based on Kim, Kim, Han & Chin (2015) acculturation refers to the process of adapting or changing one’s values, attitudes, beliefs, identity, and behaviors those result in experiencing a new culture. Assimilation comes as a necessary occurrence for immigrants based on the need to avoid the hostility that is associated with being from a minority group. Based on the stress process framework, immigrants are highly disadvantaged in society and they are more susceptible to social-related stress. Elderly immigrants are more likely to be classified under the low socio-economic setting, limited social and health services, and vulnerability to linguistic and social isolation (Cho, 2019). For this population their ability to interact with the wider population is limited and this further complicates their experiences subjecting them to more stressors. Acculturated immigrants are far off better both socially and economically when compared to those that are not fully acculturated. For most of the older immigrants, they have adapted less to the host culture which is dominant and this, therefore, implies that they have minimal resources for coping and are at higher risk or poorer changes. The situation is more noticeable for the older population since the opportunities associated with acculturation tend to change for every generation and duration of residence in the host nation.

Fox, Entringer, Buss, DeHaene & Wadhwa (2015) established that there is a positive link between the challenges of adjustment in the process of acculturation and high-stress levels among older immigrants. Low acculturation due to linguistic challenges, illiteracy, and lack of social support contributes to a high depression rate (Cho, 2019). The stress that is acquired from cultural incongruence has adverse effects on older immigrants as it affects their psychological adaptation, coping ability, and access to essential services. Even though the level of acculturation is determined by the time spent in the host country, several factors such as education level and language barrier tend to hinder a significant number of older immigrants from successfully assimilating into the host country (Tran, Jorm, Johnson, Bambrick & Lujic, 2015). Most elder people despite spending a significant part of their life in the U.S retain their attachment to their conventional cultural values and also maintain close relationships with other individuals from their respective cultural backgrounds irrespective of their residence time.

Sun, Gao, Gao, Li & Hodge (2018) found that language plays a critical role throughout the acculturative change process. It is believed that close to 30 percent of older immigrants have challenges in speaking English which is the dominant language in the U.S. in this case, language barriers are likely to hinder individuals social and economic opportunities as well as access to social and health services and the lack of exposure to the basic institution for the elderly immigrants' communities (Cho, 2019). The partial English proficiency can serve as a significant life stressor contributing to limited functionality for the group. Hence, increased English proficiency is associated with better mental health outcomes among older immigrants.

Individual Culture versus the Individualistic Culture

According to Sun, FGao, Gao, Li & Hodge (2018), culture is a vibrant system comprising of rules and beliefs that are established a group of individuals to promote their survival by adhering to a set of norms, values, beliefs, and behaviors that are unique to the specific group. The individualistic culture generally upholds uniqueness and independent values while the collectivist culture normally tries to promote individual fitting in a community. Collectivism is about group process where individuals work together without promoting independence as the individualistic culture (Kim & Choi, 2015). Most of the minority ethnic groups are collective meaning that they are focused on creating a community-based harmony.

The U.S similar to other Western countries occupies an individualistic culture compared to Eastern and Asian countries which are individualistic (Kim & Choi, 2015). Therefore, immigrants from the collectivist cultures might face intense challenges trying to attain independence where community harmony is not encouraged which creates inner conflicts. For these individuals, they only become comfortable after examining the social-cultural suitability of a given role. Attention seeking and being competitive among these individuals is not something that they appreciate in general (Cho, 2019). In such cases, the difference between the two cultures is likely to create a major challenge to the overall adaptation process as they are surrounded by people who are focused on their independence and personal achievements to gain attention from others. 

Acculturation and Social Support

As noted by Mao, W Xu, Guo & Chi (2018) social support serves as an essential factor that can be vital in mitigating stress that is normally acquired from the acculturative process. For immigrants, their social and familial networks are normally important in the acquisition of resources, information as well as emotional support. Social networks are considered as instrumental and emotional assistance that people gain from their interpersonal relationships. Social support is hypothesized as an aid that helps in diminishing the overall implications of stress on individuals’ mental health. In light of recent research, social support is perceived as an effective channel for coping with stress among older adults (Sun, FGao, Gao, Li & Hodge, 2018). The evidence of the research aligns with the notion that the components of social networks have a positive influence on the welfare of older adults’ immigrants especially those from collectivist culture. Having a wide or an intimate social network with family and friends is associated with low-stress levels hence eliminating the potential of depression. Older adults with great social support tend to experience an improved quality of life compared to the ones that lack the connection and this is consistent with their traditional norms which normally promotes interdependence.

Social support and acculturation are interlinked as they influence the quality of life experienced by older adults (Kim & Choi, 2015). Although increased acculturation among older immigrants leads to better mental health outcomes, certain cultural factors like familial, friends, and co-ethnic networks have been found to lead to lower stress levels and improved well-being. While most of the older adults tend to immigrate to the U.S in the hope of maintaining their family ties, their expectations are in most cases disrupted by the existing cultural differences which emerge as a result of their family members assimilating.

Depression among Older Adult Population

Arguably, immigration is one of the most stressful expresses for individuals seeking to assimilate into society. Changes about the social conditions and norms are challenging for older immigrants as they lack vital information that is required to fit in a society that is individualistic and less supportive of interdependence. Older people above 55 tend to experience migratory grief based on the inner conflict between their ancestral culture and norms within the host culture (Sun, FGao, Gao, Li & Hodge, 2018). For most of them, they hold the beliefs of their traditional culture very close and this normally affects their overall proficiency score in English compared to the younger population which increases their vulnerability rate. The language barrier is a factor that affects the ability of the individuals to gain great social networks leading to isolation and depression as the outcome.

Older adults particularly immigrants experience social adversities and migration-related stressors and this has negative effects on their behaviors and health outcomes. They are predisposed to depression and other chronic illnesses due to their socio-economic challenges, cultural barriers, and old-age vulnerabilities to morbidities (Cho, 2019). Low socioeconomic status remains to be a major health risk amongst older adults for depression. Most immigrants are believed to be living in a low socio-economic setting because of their limited educational achievement, lack of employment, and cultural challenges. Immigrants normally fight with feelings of psychosocial adversity and cultural challenges that affect their mental health in general (Kim & Choi, 2015). The lack of financial security also leads to stress as they are unable to afford basic services such as healthcare which they desperately require leading to depression. The feelings of hopelessness trigger deep emotions of being overwhelmed, which are associated with sadness and depression among older adults (Kim, BLinton, Cho & Ha, 2016).

Based on the above analysis of existing literature about the effect of acculturation on depression among older adults, a significant gap exists on approaches to address acculturation challenges. The issue of depression among older adults is believed to affect less than 20 percent of the population but is more dominant among immigrants. The factors that promote acculturation stressors in older adults need to be examined and suitable solutions to achieve cultural competence among social workers proposed to promote better mental outcomes among older immigrants.

Methodology

The Systematic Review

A systematic approach was utilized to review existing literature of qualitative and quantitative studies on the effects of acculturation on depression among older immigrants. A systematic approach involves reviewing past literature and the method is designed to investigate, assess, synthesize, and evaluate existing evidence with regard to a specific subject. Different peer-reviewed articles were selected for use for this study following the identified themes relating to the factors that make the acculturation of older immigrants in the U.S challenging. The articles reviewed are those that: examined the risk factors of depression among older immigrants, explored the factors that lead to improved mental health outcomes as a resulted of better acculturation and examined potential solutions for minimizing depression rates among older immigrants from the social work worldview.

The Literature Search

Articles reviewed were sourced from several healthcare databases including PubMed, Cochrane Library, Up ToDate, and EbscoHost. Peer-reviewed sources were preferred for this research based on their ability to provide reliable, accurate, and credible data. Sources published in the last five years were included in the study while those older than five years were eliminated based on their inability to offer relevant and timely data. The articles were generated by including one or more search terms and phrases such as depression, acculturation, and older immigrants. For the initial search, 800 articles were retrieved but most of them were eliminated particularly those that are not free to access. A large number of articles created a limitation since large exclusion criteria had to be applied to eliminate a significant number of sources. Articles published in the last 10 years were more compared to the ones published within the last five years.

Data Analysis

In analyzing data collected in the systematic review, thematic analysis was selected as the appropriate approach. The objective of the study was to establish the overall effects of acculturation on depression among older immigrants. The study hypothesized that acculturation challenges contribute to higher depression levels among older immigrants. Thus, the data were summarized and classified three themes including acculturation level, social support and acculturation, and social support and acculturation.

Challenges and Limitations

Similar to any other study, this systematic review study was subject to several challenges and limitations. The main limitation faced by the study is a large data source. The search resulted in a significant number of articles which made it rather challenging to summarize and simplify the data. Narrowing the scope of research was challenging based on the availability of an extensive range of information. However, by focusing on the studies conducted in the U.S this was vital in guarding the reliability and credibility of the study.

Appendices

Search Strategy

A systematic approach was utilized to review existing literature of qualitative and quantitative studies on the effects of acculturation on depression among older immigrants. A systematic approach involves reviewing past literature and the method is designed to investigate, assess, synthesize, and evaluate existing evidence with regard to a specific subject. Different peer-reviewed articles were selected for use for this study following the identified themes relating to the factors that make the acculturation of older immigrants in the U.S challenging. The articles reviewed are those that: examined the risk factors of depression among older immigrants, explored the factors that lead to improved mental health outcomes as a resulted of better acculturation and examined potential solutions for minimizing depression rates among older immigrants from the social work worldview.

References

Cho, S. (2019). Acculturation and Depression among Older U.S. Immigrants: A Systematic Review. Retrieved from: https://sophia.stkate.edu/msw_papers/866

Fox, M., Entringer, S., Buss, C., DeHaene, J., & Wadhwa, P. D. (2015). Intergenerational transmission of the effects of acculturation on health in Hispanic Americans: a fetal programming perspective. American journal of public health, 105(S3), S409-S423. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455494/

Kim, B. J., & Choi, Y. (2015). The relationship between activities of daily living (ADL), chronic diseases, and depression among older Korean immigrants. Educational gerontology, 41(6), 417-427. https://www.tandfonline.com/doi/abs/10.1080/03601277.2014.982006

Kim, B. J., Linton, K., Cho, S., & Ha, J. H. (2016). The relationship between neuroticism, hopelessness, and depression in older Korean immigrants. PloS one, 11(1), e0145520. https://www.researchgate.net/publication/289355475_The_Relationship_between_Neuroticism_Hopelessness_and_Depression_in_Older_Korean_Immigrants

Kim, J., Kim, M., Han, A., & Chin, S. (2015). The importance of culturally meaningful activity for health benefits among older Korean immigrant living in the United States. International Journal of Qualitative studies on Health and Well-being, 10(1), 27501.

Mao, W., Xu, L., Guo, M., & Chi, I. (2018). Intergenerational support and functional limitations among older Chinese immigrants: Does acculturation moderate their relationship?. Journal of Ethnic & Cultural Diversity in Social Work, 27(4), 294-309. https://www.researchgate.net/publication/327756577_Intergenerational_support_and_functional_limitations_among_older_Chinese_immigrants_Does_acculturation_moderate_their_relationship

Sun, F., Gao, X., Gao, S., Li, Q., & Hodge, D. R. (2018). Depressive symptoms among older Chinese Americans: Examining the role of acculturation and family dynamics. The Journals of Gerontology: Series B, 73(5), 870-879. https://pubmed.ncbi.nlm.nih.gov/27048568/

Tran, D. T., Jorm, L., Johnson, M., Bambrick, H., & Lujic, S. (2015). Effects of acculturation on lifestyle and health status among older Vietnam-born Australians. Asia pacific Journal of public Health, 27(2), NP2259-NP2274. https://www.researchgate.net/publication/249649046_Effects_of_Acculturation_on_Lifestyle_and_Health_Status_Among_Older_Vietnam-Born_Australians

“Exploring the effectiveness of music therapy as part of nursing care for patients living with dementia”

Introduction

People living with dementia undergo various psychological challenges in life. Therefore, it is crucial to make interventions that could make their lives better. Music therapy is perceived as one of the major interventions that can help the patients as part of the nursing care. Therefore, caregivers face various music-based interventions that could fit their patients to deliver the best results. The major options music therapy, forming groups to sing as well as listening to various music genres to boost their psychological well-being. In this case, music therapy is explored further in this study as a major intervention among dementia patients based on its stimulating aspect.

According to The American Music Therapy Association, it involves a clinical way of using music geared toward achieving a certain goal with the help of a credentialed professional. In this case, dementia patients require the music therapeutic relationship that addresses their needs physically, emotionally, cognitively, and socially. The significance of having a professional therapist is to assess the strengths, needs of every dementia patient, and decide the most suitable musical routine or song choice. As a result, the patients can be helped through new and dedicated music creation that addresses their situation. Alternatively, the patients will be required to sing along, make some moves as they listen (McDermott, Orrell and Ridder, 2014). As a result, the patients achieve stronger abilities that will help them in daily life through better communication and overcoming difficulties when expressing themselves using words. The effectiveness of music therapy facilitates rehabilitation, motivation, and trigger movement during the treatment sessions. Further, it leads to emotional support to all stakeholders related to the patient as feelings expression is eased.

Studies reveal that music acts as a stimulating medium and it is accessible in various means. Therefore, dementia patients can use it alone, in the company of their family or caregivers. As a result, most care homes hosting dementia patients and families have adopted music listening, singing, and dancing as part of their daily activities (Harmer & Orrell, 2008). It is also clear that modern societies recognize music as part of life, which makes it a universal language that can be enjoyed by people of all ages and backgrounds. Music tends to stick in mind despite other distractions to cognitive functionality.

Notably, the effectiveness of music therapy has not been exhausted in the current studies because the theoretical framework of dementia care is limited. The available studies have not elaborated strong theoretical frameworks to elaborate on the degree of effectiveness based on the best method and necessity of music therapy towards benefiting the psychological well-being of dementia patients (McDermott, Crellin,  Ridder  & Orrell,  2013). Therefore, this study will consolidate current studies to determine if the studies have identified a sustainable theoretical model for incorporating music therapy as part of caring for people living with dementia. The presence of different findings and results from studies is not enough if they cannot address the effectiveness of music therapy as a tool to be used by nursing caregivers dealing with dementia patients.

Therefore, this study will engage people living with dementia and their nursing caregivers directly to understand their social life and how they relate with the people around them. There are many dynamics of life exhibited by these patients, which can be physical, emotional, or social. For example, it will be significant to understand if music therapy can address all these aspects or it should be targeting either personality, physicality, social, or biological healing. In addition, the impact of music has to be targeted to certain patients' such as psychosocial factors.

According to Alzheimer's Research UK (2021), The latest study revealed that people living with dementia in the world are approximately 50 million. This is very saddening and measures should be taken to prevent the prevalence. It is further projected that the population suffering from Dementia may triple by the year 2050. These are not just mere statistics and there is a need to address the issue in totality. The cases of people already living with the problem are important to ensure the society is catered for. Therefore, the study will be crucial for the people already affected to ensure the damage is reduced significantly, as the patients undergo musical therapy. It will not only help the patients but also the caregivers and the members of their families.

Aims and Objectives

1. To investigate the aspect of music therapy and its value to people living with dementia.
2. To explore the understanding and perspectives of nursing caregivers, families, and professional music therapists on the effectiveness of music to patients living with dementia.
3. To create a comparison and connections found between psychosocial factors and the findings derived from the study findings to determine the suitable music therapy theoretical model that can help patients living with dementia.

Methodology

References list

Alzheimer’s Research UK, (2021),  Dementia Statistics hub: Global prevalence, Available from             https://www.dementiastatistics.org/statistics/global-  prevalence/#:~:text=Globally%2C%20the%20numbers%20of%20people,2050%2C%20a            %20204%25%20increase.

Harmer, B., & Orrell, M. (2008). What is meaningful activity for people with dementia living in care homes? A comparison of the views of older people with dementia, staff and family             carers. Aging & Mental Health, 12(5), 548–558. doi:10.1080/13607860802343019

McDermott, O, Orrell, M & Ridder, HM, (2014), The importance of music for people with           dementia: the perspectives of people with dementia, family carers, staff and music     therapists, Aging & Mental Health, 18:6, 706-716, DOI: 10.1080/13607863.2013.875124

McDermott, O., Crellin, N., Ridder, H.M.O., & Orrell, M. (2013). Music therapy in dementia: A narrative synthesis systematic review. International Journal of Geriatric         Psychiatry, 28(8), 781–794. doi:10.1002/gps.3895 

The Practice of Treating Addiction

1. Thanks for taking the time today to be with us. Recently there have been a lot of news stories related to addiction treatment, but we also hear terms like recovery, rehab, and therapy. I’m wondering if you can help our viewers understand exactly what treatment is, and how it might be different than some of the other terms or images we may have seen on TV?

Treatment is the act of encouraging independence, showing empathy, being compassionate, encouraging rational thoughts through engagements that show that there is a possibility for recovery. This is done using contingency supervision which seeks to reduce harm to the patient. In the earlier years, the therapeutic communities used behavioral modification ideologies to encourage positive behavior changes that promoted recovery. These methodologies worked well for the residents at the time. It is important to note that as of now, addiction cannot be cured, meaning that there is no available way to bring back the brain of a patient who is dependent on a substance to where it was before they began abusing. One effective treatment is when a patient learns to change their lifestyles and begin to be in control, be industrious, and live a meaningful life (Carroll 2016). In the medicinal methodology of treatment, there is the use of pharmaceuticals which help to address several significant dysfunctions in the brain that are connected to addiction. Pharmaceutical cannot be able to address all the other social, economic, and political aspects and therefore require other interventions to be incorporated for it to be effective. Evidence-based practice interventions which include therapies such as behavioral therapies, coping skills, and other types of counseling programs are effective for addiction treatment because they focus on the individual and what they are struggling with. Combining the evidence-based practice with a universal treatment methodology that includes the earlier approaches yields better treatment results. A follow-up is done on the patient by their therapist or counselor to ensure that they can use the skills learned to cope in society and offer them moral support to do so.

2. Thanks for that insightful response. My next question relates to the best practices for the type of treatment programming you described. What should individuals or families be looking for in an addiction treatment program? 

In an addiction treatment program, approaches such as contingency management are used. This is a type of behavioral therapy that uses motivational incentives or rewards to enable an individual to abstain from drugs and alcohol. This approach helps to encourage soberness and actions that uphold a healthy existence. Rewarding clients when they can make lifestyle changes make them more determined to achieve their goals. Psychotherapies is another approach used in the addiction treatment program. This is the use of psychological methodologies to help a person change their behavior and is aimed at improving their cognitive and behavioral difficulties (Carroll & Rounsaville 2010). Behavior therapy focuses on learning how to develop the usual and unusual behaviors. Cognitive therapy focuses on people’s thoughts rather than what they do and this includes their emotions too. Humanistic therapy emphasizes the capability of an individual to make a rational choice and develop to their maximum potential. The holistic therapy also part of the treatment program is a blend of different approaches, tailored to fit the needs of the client. Pharmacotherapy is the use of medication which is also used in the program whereby medicines are used to decrease the strength of withdrawal symptoms. These kinds of medications also decrease alcohol and other substances cravings and the probability of consumption or relapse for particular drugs by stalling their impact. With the increase of technology, computer-assisted therapies are also available and this is a type of psychotherapy that uses a computer program to deliver an important part of therapy content.

3. And exactly how effective are these sorts of treatments?

These sorts of treatments are effective because each of the patients is treated according to their needs and the treatments are patient-centered to ensure that they serve the patient effectively. For a treatment to be effective, the person being treated has to be ready to address their addiction and by using these kinds of treatment, they will benefit the patient. Therapies help the patient treat their addiction problem while they develop new habits, behavior, and coping skills for recovering addicts. Medication is important in addiction treatment but when used alongside other kinds of psychotherapies and behavior therapies it becomes effective and serves the patient holistically. To address mental health conditions in a patient, these kinds of treatment work effectively because they use treatment methods that focus on their mental health (Hunsley, Elliott & Therrien 2013). This sorts of treatment allow the patient to be regularly assessed and if the method is not working for the patient, it is easy for it to be modified to fit the needs of the patient. Psychotherapy is important and makes the addiction treatment effective because addiction to drugs does not only mean being dependent on the substance but once detox is finished, and the body is no longer dependent on the substance, there is still a possibility of relapsing. This is because social and psychological factors can easily trigger a person to return to drugs. Psychotherapies ensure that the patient gets the required support even after their successful detox and the patients get the required skills and care that they need during this time.

4. Great, and would you say treatment programs can work for people from all walks of life, and if so, how do you ensure your services are being delivered in a culturally appropriate manner? 

Treatment programs work for every individual despite their culture or background. To ensure that the treatment services and programs are offered in a culturally appropriate manner, cultural competencies are followed. Cultural competence is the process where the one offering the treatment services attempts to accomplish the capability to work efficiently within the cultural framework of the person. This means following cultural competence components which include cultural awareness which is the self-evaluation of a person’s own culture and professional background. Cultural knowledge is important in ensuring that culturally appropriate services are offered. Cultural knowledge is the process of pursuing and gaining information about diverse racial and ethnic groups. Another cultural competence component is having cultural skills. Cultural skill is the capability of collecting significant cultural information that concerns the problem that the client presents and being accurate in conducting a culturally specific physical evaluation (Campinha-Bacote & Munoz 2001). Cultural encounter is another component that encourages direct commitment to cross-cultural relations with clients from culturally varied upbringings. Having cultural desire when offering addiction treatment to culturally diverse clients is an important component in ensuring that culturally appropriate treatment is offered. This is because cultural desire acts as a motivation to engage in the treatment process of becoming culturally aware, gaining knowledge and skills in seeking cultural encounters. Being culturally competent ensures that the cultural differences are respected, it builds on the strengths of a person’s cultural background and identifies any similarities between the client and their therapists. This ensures that the client gets culturally appropriate treatment services.

5. I’ve read somewhere that most people return to using at some point in time once they leave treatment. I’m wondering if you can speak to this and offer advice to individuals and families who may be in the midst of this process.  

Relapse is a slow progression with different stages and the main objective of treatment is to help clients identify the initial stages which have a high chance of being successful. Some of the main types of relapse include emotional relapse and through this relapse, people don’t think about using. Their emotions and behaviors are the ones that set them up for relapse. Signs of emotional relapse include holding up lots of emotions, isolating themselves, poor eating and sleeping problems among others. Therapy at this stage helps the client to realize what self-care is and the reason why it is essential. Self-care differs from one person to the other, some may require basic self-care such as diet and hygiene but for most clients, it is more about emotional self-care. Therapy helps clients identify their denial by comparing their behavior to know if their self-care is improving or getting worse (Melemis 2015). When a client gets a mental relapse it means that there is a battle inside their minds, battling if they should use or not use. When people get more into mental relapse, their cognitive resistance weakens and their need for escape escalates. Signs of mental relapse include cravings, having thoughts about people or places that are related to their past use, lying, and planning for relapse among others. Therapy at this point helps clients to avoid high-risk situations. Physical relapse is when an individual begins to use the substance again. Physical relapses mostly are relapses of opportunities. When a person gets a chance that they feel that they won’t be caught a relapse is likely to occur. This is the hardest stage to stop and the reason why people relapse. People need to learn about the essential coping skills for them not to return to drugs and alcohol to escape their situations.

6. For all the folks out there struggling with substance use, who may have tried treatment or counseling previously with little success, what advice would you have?

It takes a lot more than treatment and counseling for a person to successfully stop being dependent on a substance. First of all, you as the patient should be willing to go through all these stages of treatment and have a positive mind. Developing healthy coping skills is key to avoid the negative thinking that makes the treatment not to be successful. Negative thoughts such as, “I cannot handle a situation without using, I do not want to change my friends, life will be boring and recovery takes a lot of time” among others are some of the thoughts that interrupt the recovery process (Melemis 2015). The moment you as a person gives in to the negative thoughts, you convince yourself that it is not possible and it is too much work. These thoughts cause anxiety, depression, stress, a person becomes resentful and this can lead to a relapse. For treatment to be successful, a person has to be committed and true to themselves, own up to their mistakes, and identify with the help of their counselor which strategy to use when they start having negative thoughts. A person ought to learn from setbacks because the way an individual deals with a setback plays a big role in their recovery. It is important to note that setbacks are part of the progress and are normal. They are brought about by inadequate coping skills or planning which are disputes that can be amended. During recovery, patients ought to learn how to feel comfortable with being uncomfortable. The negative feelings and emotions are normal and are not signs of failure.

7. Now I imagine there are several people out there who might not be ready for therapy, but who may need help organizing their lives and figuring out what they want to do. Is that possible or is counseling the only service available? 

The first rule for such people is to change their lives and the way they live. Recovery is not achieved only by not using substances. It involves developing a new life whereby it is easier not to use. When a person is not willing to amend their life, then everything that led to their addiction, in the long run, catches up with them. Avoiding people, places, and things that are associated with substance use is important. People need to completely be honest with themselves, their mistakes, and work towards correcting them. People can talk to their family members about their plan to stop using or could join a self-help group where people share their experiences and offer support to each other (Melemis 2015). When a person chooses a recovery circle, it is important for them to be honest because it is significant in their recovery. Joining a self-help group increases the chances of a person getting a full-term recovery. In the self-help groups, the person feels that they are not alone, they hear other people talking about their addiction and they learn how other people achieved or are on their way to achieve recovery. They also can learn about the coping skills that have worked for others and the best part about it is that they have a place that they feel secure to go to where they do not get any judgment. Self-help groups support people in overcoming their shame and guilt about addiction seeing that they are not alone and this acts as a motivation for their recovery.

8. Great, I’m wondering if you have any advice for anyone out there who may be accessing the help that doesn’t seem to be helping. What should they do, and is the right way to end services and find something that might be more helpful?

For an individual to achieve successful counseling, they ought to have a significant change in the way they feel, act, or think. If the counseling relationship appears not to be helpful, termination is appropriate. The counselor needs to discuss with the client about termination immediately they notice the signs that the client is not committed. Discussing it helps them identify what the problem is and know if it could be resolved and if not termination is allowed. When the counselor finds that the client wants to quit, an exit interview may be done to help the client resolve any negative feelings that could have been a result of the counseling experience. An exit interview is also a way of inviting the client to continue with counseling if they wish to. In an exit interview, another counselor or strategy might be considered if the client is willing and it also increases the chances of the client considering counseling again if they need help (Gladding & Alderson). In this case, the client feels that they are not getting the help that they need or expected, and the termination is appropriate. The client should discuss openly with their counselor their reasons for termination. This will help the counselor not beat themselves up about the termination. They may even come up with a solution or suggestion on what you should do to get the help that you need.

9. Last question. For many of our viewers, your work seems intense, meaningful, and potentially draining. What would you say are the keys to maintaining healthy work-life boundaries? 

Taking care of yourself is important because experiencing job stress and burnout in our career is inevitable and normal. Maintaining a healthy work-life boundary includes remembering your mission. Since our career’s mission is to facilitate the survival of people with mental illness and help them live a productive life in society, we have to accomplish that. Accomplishing the mission is so fulfilling seeing that a client has been able to achieve their goals (Eack, Anderson & Greeno 2013). Defining your job in a way that makes it doable is important in our career. Professionalism is key for us and it means doing whatever it takes to get the job done. Sometimes the days are long, working for many hours but there are days that the demands are minimal. This is where you balance and take advantage of the minimal demanding days to take it easy on the job. Making reasonable schedules with the clients is also important so that none of you gets frustrated. It is also important to nurture yourself in your career. This involves accepting that your needs are also legitimate and require your attention. Self-care includes taking care of your mental and physical health by getting enough sleep, have healthy eating, and exercise lifestyles. Listening to your body and maintaining an attitude of self-acceptance by avoiding negative self-talk helps in keeping you energetic and positive. We need to maintain a healthy balance between our profession and personal lives to be able to maintain a healthy work-life boundary.

References

Campinha-Bacote, J., & Munoz, C. (2001). A guiding framework for delivering culturally

competent services in case management. The Case Manager, 12(2), 48-52.

Carroll J. F. X. (2016). What constitutes “Success” in addiction Treatment and How Do We

Determine What Works Best? Alcoholism Treatment Quarterly, 34:2, 252-260

Carroll K.M. & Rounsaville B.J. (2010) Society for the Study of Addiction Journal Compilation

Eack S.M., Anderson C.M. & Greeno G.C. (2013). Mental Health Case Management: A

Practical Guide: Taking Care of yourself. SAGE Publications, Inc.

Gladding T. S & Alderson G. K. Chapter 8: Termination of Counseling Relationships.

Hunsley, J., Elliott, K., & Therrien, Z. (2013). The efficacy and effectiveness of psychological

treatments. Ottawa, Canada: Canadian Psychological Association.

Melemis, S. M. (2015). Focus: Addiction: Relapse Prevention and the Five Rules of Recovery.

The Yale journal of biology and medicine, 88(3), 325.

 The Role of Capitalism as it Pertains to the Pandemic

            The Covid-19 Pandemic is a health crisis that has put the global economic, social, and political systems on the verge of collapse. Its sudden onset, rapid transmission, and potential to cause mortality magnified by the current lack of a working vaccine. The Pandemic has global ramifications in the social, political, environmental, and economic dimensions. The unemployment rates have risen to unprecedented levels. Businesses have closed with unlikely ever to recover. While public and private debts have escalated as borrowings increase to sustain the economies in recession. The current review explains the role of capitalism before and during the Covid-19 Pandemic. It further looks at likely scenarios as countries seek to emerge post-pandemic.

Role Played Before the Pandemic

            Capitalism is a political and economic system where most of the capital and control of trade and industry falls in private players' hands rather than the state. Indeed, capitalism played a role in making the coronavirus outbreak a pandemic as restrictions were minimal early on to avoid hurting the economies (Pennington and Stanford 165). The lessons learned have made governments less worried about reviving the economy and more about taming the Pandemic. Unions, charities, and community groups have had to play a more significant role in ensuring human health is the priority and alleviating the suffering through simple acts as providing a meal to those in self-isolation.

            After the 2008 Global Financial Crisis (GFC), the states increased calls to de-regulate the economies. However, what resulted was increased austerity and intensification of institutionalized financing (Primrose 18). The Pandemic is unlikely to shift away from neoliberalism, whose characteristics include lowering trade barriers, capital markets deregulation, and eliminating price controls. The reforms implemented by the Western governments since the outbreak of the Pandemic cannot address the impacts of more than four decades of embedded capitalism.

            The detrimental form of capitalism that led to the GFC in 2008 resulted in many countries struggling with austerity and increasing economic inequalities. The outbreak of the Pandemic saw many states unable to deal with the outbreak as it exposed their socio-cultural weaknesses. The rapid spread exposed the healthcare economizing characteristics inherent in many countries today. Because of the social austerity characteristics of escalating public and private debts, the healthcare systems exhibited diminished capacity (Rosenwarne 32). The healthcare systems struggled to deal with the spiraling numbers of hospitalizations and mortality characteristic of an epidemiological outbreak such as Covid-19.

            From its onset, the Pandemic threatened to overwhelm healthcare systems' capacity as they struggled to provide the in-patient care urgently needed (Council of the EU). The overloaded care systems could not cope with the surging numbers resulting in unnecessary and preventable deaths. The lack of preparedness is attributable to national policy failures over a long period (Lyon-Callo 54). Healthcare and response systems' need to improve on profitability has impacted the service delivery and capacity levels. A good example is the austerity measures implemented in Italy and Spain over the last decade. The European Union has been urging the countries to cut back on public spending and privatize most of its institutions. On the other hand, cost-cutting measures by care systems in the United States over many decades have seen many become profit-seeking entities rather than providing holistic care.

            Other countries are faring any better, with cutbacks being the following scenario. Even countries such as Canada that should not suffer from the problem because of its single-payer healthcare system have been subject to cost-cutting measures since the 1990s. According to the OECD's statistics, 1,000 citizens have only 2.5 hospital beds from a high of 7 to share (Heenan and Sturman 199). The countries with the least amount of hospital beds shared among its citizens exhibit worse scenarios of preventing unnecessary deaths from the Pandemic. Countries such as Germany that have resisted pressure to downsize their healthcare systems have seen fewer deaths than Spain and Italy.

            However, healthcare shortfalls alone cannot take all the blame for the global crisis brought about by the spreading of the Pandemic. Before the problem became a pandemic and more information about it was known, seniors and people of advanced age were established to be affected disproportionately. Nevertheless, most public policies have long segmented the population as “unproductive” to society (Jones 99). Most of the care systems seeking to maximize profitability have targeted long-term care for seniors for cuts. The accommodation systems for the population have become social amenities subject to privatization and aggressive cost controls. The outcome has increased outbreaks in the privatized institutions increasing mortality rates among seniors. Over half of the deaths have occurred in long-term care homes, with most of them being commercial entities. Cost controls mean most healthcare workers in the facilities are lowly paid and do not have access to the necessary protective equipment. The healthcare and personal care providers have been unable to contain the virus, with most becoming agents of spreading the illness.

            The Pandemic has affected individual races, poor and working classes adversely (Leigh 58). The disproportionate impact further shows the outcomes of the capitalistic public policies. The groups do have the luxury of minimizing interactions or social distancing effectively. They exhibit elevated risks due to their inability to discontinue low paid work. Most have underlying medical issues that make them susceptible to contracting and succumbing to the illness. The statistics indicate that Pandemic affects races and classes disproportionately. The inequality is rampant in urban areas where there is downward pressure on incomes. The areas are characterized by crippled social support leaving the population at elevated risk. The responses to eliminating the inequalities in the societies cannot be tackled amidst a health emergency. The Pandemic has exposed the inequalities and other social problems inherent in our capitalistic societies, which must be addressed going forward.

Role Played During the Pandemic

            The reaction of Western countries towards Covid-19 has not been sufficient. They have mainly turned to techno-managerial policies to mitigate the effects. They have ignored the social antagonisms brought about by social struggles and ideological differences in capitalistic economic policies (Barker 28). The response has focused on techno-managerial planning, expert administration, and consensual governance.

            They soothe the contentious public issues resulting from institutionalized foundations of capitalism and neoliberalism. They ignore the problems as not falling in the domain of political consideration (Tham 79). The responses to the Pandemic by many governments indicate the logic of framing the outbreak as a matter relating to national security rather than a global health crisis. They have equated the global crisis to other outbreaks such as Ebola and Swine Flu. They view the Pandemic as threatening the existence of political, economic order. The logic is that the Pandemic is an unforeseen problem that could not have been predicted. Therefore, to secure the political-economic order, it must be contained by all means possible through emergency measures.

            The framing of the responses has been mostly in metaphorical war terms to contain the crisis. The new cultural politics of capitalism utilizes imaginary apocalyptic threats as a central theme. The positions paint the Pandemic as an existential threat that the current systems can manage. The framing as a securitized threat allows the political leaders to neglect the political economy and focus on immediate imperatives to contain the outbreak. The result is managing the symptoms rather than solving structural underpinnings.

            The view reduces the Pandemic to an unforeseeable one-time event disrupting an otherwise healthy, rational economic system. It ignores pre-pandemic research showing how social strife and unequal health applications resulting from capitalism exacerbate the problem. The political class creates an imaginary enemy to maintain the fear, uncertainty, and danger among the masses while reassuring them that the socio-economic elites and techno-scientists possess the necessary mechanisms to tackle the crisis (Ranald 112). The aim is to maintain the status quo. Through the solution, political transformations become unnecessary.

            The crisis brings into focus the social regeneration required to ensure capitalism's survival (Berry 44). Implementing social distancing effectively requires suspending social interaction integral to employment and consumption. Yet, the responses have not been up to par exemplified in economies such as those in the U.K. and U.S. The focus is on reviving the economy while risking the extensive loss of lives. The example is valuing capitalism over human life by shoring up economic processes until the containment of the outbreak.

            The response by experts has mostly focused on modifying individual behavior. They have focused on nudging people to adopt responsible heal behavior. The aim is to avoid regulation by utilizing behavioral economics to steer people towards rational tendencies. The experts' notion that quarantining people early on could have led to discipline issues when it finally reached peak levels. The governments adopted awareness campaigns such as television advertisements to encourage good personal hygiene, wearing masks, and observe social distancing. The responses are similar to those adopted in other pandemics such as Ebola and HIV/AIDS.

            Focusing on individual modification ignores public issues such as reforming the economic reality that the health care systems are weak. The result is governments ignoring the extensive social reforms that go beyond self-quarantining. The initial responses by the World Health Organization and the government to contain the outbreak should have been implementing large-scale testing, training more healthcare personnel, and building more health institutions. The reality is that capitalism and neoliberalism are central to the politics of rendering public health.

What is Likely to Emerge Post-Pandemic?

            The economic recovery is likely to be slow as many countries fall into recession. The labor unions are likely to play a more significant role as disputes over a return to work formula increase, and business owners negotiate wage freezes (Quiggin 41). There is a need for flexibility and simplification of processes in the economy to allow for successful rebuilding. The simplification of the enterprise bargaining system is likely to result in more benefits for the workers.         

            The likely scenario post-pandemic is implementing tax cuts, pursuing deregulation aggressively, and initiating industrial relations reforms. The government's view is similar to that of employers. The governments are likely to pursue the path though it has failed to yield the past's expected results. Stimulating demand and overall productivity were reforms that were needed even before the crisis (Centeno 45). Therefore, the reforms that are likely to yield expected results correct the effects of the adverse distribution worsened by the crisis, such as wage inequalities and securing the positions of casual and gig workers.

            The nature of work will likely see significant changes. Employees have had to undergo retraining, such as specialized doctors re-purposing to work in the Emergency Room. A significant number of employees globally are currently working from home, a trend that is likely to continue post-pandemic. Working remotely is likely to improve productivity by allowing regaining costs and time by reducing commuting to work (Heenan and Sturman 194). The trend is also likely to reduce congestions on the transport systems. However, the trend is also likely to have adverse effects such as the workers' exploitation because of the lack of clear demarcation between leisure and work.

Conclusion

            Underemployment and unemployment are likely to persist for some time, even post-pandemic. The unions are likely to be weaker as they have had to accept significant regulatory changes. Although some work changes are positive, many challenges will need navigating in the medium and long-term for employers, workers, and government. Capitalism's reliance on lowly-paid and marginalized groups have prevalent during this period. The norms and patterns are likely to persist when the wartime spirit of coming together fades. The attempt to alter industrial relations and deep wage cuts to fuel the capitalistic enterprises is likely to lead to social strive. The Pandemic has brought in new norms, some likely to stay while others like addressing inequalities due to capitalism will lead to increased calls for reforms.   

Works Cited

Barker, Drucilla. “The Other Side of the Portal: COVID-19 and the Crisis of Social Reproduction.”. “in Pandemic and the Crisis of Capitalism: A Rethinking Marxism Dossier.” edited by the Editorial Collective of Rethinking Marxism. Brighton, MA: ReMarxBooks, pp. 28-36

Berry, Michael. “The Strange Death of Neoliberalism.” Journal of Australian Political Economy, no. 85, 2020, pp. 44-51. Accessed 28 Nov. 2020.

Centeno, Ramón. “Pandemonium: The International Situation after COVID-19.” “in Pandemic and the Crisis of Capitalism: A Rethinking Marxism Dossier.” edited by the Editorial Collective of Rethinking Marxism. Brighton, MA: ReMarxBooks, pp. 39-48.

Heenan, Natasha, and Sturman, Anna. “Sustainability Beyond the Economic Crisis: Labour, Nature, Capitalism and Covid-19.” Journal of Australian Political Economy, no. 85, 2020, pp. 193-200. Accessed 28 Nov. 2020.

Jones, Evans. “Covid-19 Hits the French Health System.” Journal of Australian Political Economy, no.85, 2020, pp.94-101. Accessed 28 Nov. 2020.

Leigh, Andrew. “We Can’t Coronavirus Worsen Inequality.” Journal of Australian Political Economy, no. 85, 2020, pp.57-62. Accessed 28 Nov. 2020.

Lyon-Callo, Vincent. “COVID and Capitalism: A Conversation with Richard Wolff.” “in Pandemic and the Crisis of Capitalism: A Rethinking Marxism Dossier.” edited by the Editorial Collective of Rethinking Marxism. Brighton, MA: ReMarxBooks, pp. 54-64

Pennington, Alison, and Stanford, Jim. "Rebuilding After Covid-19 will Need a Sustained National Reconstruction Plan." Journal of Australian Political Economy, no. 85, 2020, pp. 164-175. Accessed 28 Nov. 2020.

Primrose, David, Chang, Robin, and Loeppky, Rodney. “Pandemic Unplugged: Covid-19, Public Health and the Persistence of Neoliberalism.” Journal of Australian Political Economy, no. 85, pp 17-29. Accessed 28 Nov. 2020.

Quiggin, John. “Crises and Recession as the Norm.” Journal of Australian Political Economy, no. 85, 2020, pp. 39-44. Accessed 28 Nov. 2020.

Ranald, Patricia. “Covid-19 Pandemic Slows Global Trade and Exposes Flaws in Neoliberal Trade Policy.” Journal of Australian Political Economy, no. 85, 2020, pp. 108-115. Accessed 28 Nov. 2020.

Rosenwarne, Stuart. “From One Crisis to Another the Underlying Malaise in the Australian Economy.” Journal of Australian Political Economy, no. 85, 2020, pp. 29-39. Accessed 28 Nov. 2020.

Tham, Joo-Cheong. “The Covid-19 Crisis, Labour Rights and the Role of the State.” Journal of Australian Political Economy, no. 85, 2020, pp. 71-84. Accessed 28 Nov. 2020.

Journal for Gonorrhea

Summary

Gonorrhea is a global medical problem. The World Health Organization reports indicate that more than 2.6million cases are reported annually in the USA alone. Out of these cases, 1.3million are men; hence the remainder is women. Gonorrhea has a dissimilar epidemiologic specific feature, which is thought to be developmental in nature, implying that the observable traits of the illness must be first comprehended before designing or modeling the disease for the sake of predicting its mutation. The symptoms, spread symptoms, complexities, and management of gonorrhea have advanced with time. Neisseria gonorrhea is a common bacterial infection due to the generation of resistance to antibiotic treatment. N. gonorrhoeae can rapidly acquire resistance to numerous antibiotic medication. The infection has gradually become resistant to sulfonamides and other classes of medications; as the years pass, the rates of infection rise. For instance, in the USA, in 2011, 100 cases were reported in 100,000 people. In Canada and the USA, Gonorrhea is prevalent among young people.

Introduction

Neisseria gonorrhoeae is obligate and has a cell cover made up of internal cytoplasmic skin, a central section, and an external layer (Taylor et al., 2018). The external layer consists of lipids, endotoxins, and other proteins that help the illness invade tissues and resist the host's defense mechanisms.  Due to the severe and social medical impacts of gonorrhea, medics usually advise medics to use three diagnostic levels to identify the illness without any misdiagnosis. A concentrate gonorrhea diagnosis should be acquired for medical and legal reasons. A suggestive diagnosis is distinct through the occurrences of mucopurulent endocervical during the physical evaluations (Alirol et al., 2017). Additionally, a presumptive gonorrhea diagnosis should consist of- gram-negative evaluations, growth of gram-negative from the infected person, and finally, the detection of gonorrhea bacteria. The observation of gram-negative, intracellular cells under the microscope is an indication of gonorrhea infection.

Pathobiology of Gonorrhea

Gonorrhea, a sexually transmitted illness, is known for causing inflaming the mucus membrane within the genital tract and urethra. The inflammation stems from the gonococcus- a bacterium responsible for destroying the mucous covering along the genital tracts and other nearby areas. All gonococcal diseases are passed on through sexual contact with an infected person. Gonorrhea is common due to its extensive spread across the world. The rise in gonorrhea cases takes place occasionally (Fairley et al., 2017). The rising cases are partly responsible for the drug-resistant N.gonorrhoeae and inconsistent sex norms. Mortality rates of gonorrhea are insignificant, but the indirect impact gonorrhea has had on the population over the years is innumerable. For example, gonorrhea can cause sterilization in both men and women.

The gonorrhea incubation phase is normally3-5 days. Burning sensations characterize the initial stage in men. While urinating, men experience urethral discharge, which might go unnoticed or be noticed (Taylor et al., 2018). Without medication, the illness normally spreads further and deeper into the upper sections of the urethra, the sections of urinary bladder prostate glands. Insistence and regularity of urination and rarely, blood mixed with urine are some of the most visible signs of the illness. Impulsive recovery might occur in the next number of days or years after a person acquires the disease. Specifically, among homosexuals, rectal gonorrhea infests the perianal regions of the body and affects stool flow during excretion.

 The initial indications in women are mild and can go unobserved most of the time—insignificant vaginal discharge accompanied by inflammations. The illness normally goes unnoticed by patients or even medics until some difficulties emerge. Sores around the Bartholin gland occur during the initial stages of the disease. Most women recuperate suddenly from gonorrhea illnesses, which cannot spread further than the uterine cervix. In most cases, the illness spreads via the uterus into the fallopian tubes, leading to a condition known as pelvic inflammatory illness (Choudhri et al., 2018). Fever, normally coupled with abdominal pain, is a primary sign of this particular sexually transmitted disease. Some of the symptoms are similar to appendicitis. Remedial takes place without resorting to surgical medication. Nevertheless, gonorrhea might lead to sterilization and even physical disability. Among young women, the infection affects the functionalities of the vagina. Gonorrhoeae can occasionally go into the bloodstream leading to gonococcal infection in all the organs found in the patient's system. In both women and men, arthritis might manifest as a result of gonococcal infection. The mechanism of settling more than one joint infection leads whenever there is no medication.

Aetiological Agent

 The disease's evolving nature dictates how medics handle the dynamics of the infection and how they contain its spread from one person to another. As confirmed in the past, Neisseria gonorrhoeae is an etiological agent for gonorrhea (Hook III, & Kirkcaldy, 2018). After one acquires the disease, the immunity declines; hence a person can be infected more than once. Generally, the illness is a multifaceted mucus infection tied to pustular discharges. Supplementary severe inflammatory infections lead to sterility and even ectopic pregnancy. Sometimes, the disease can flow into the blood leading to infection of the blood. Annually, gonorrhea infections are 60million. In terms of medication and curability, gonorrhea is prone to a group of antibiotics. Antibiotic resistance is growing into a primary source of concern; presently, third-generation cephalosporin is recommended for the medication of gonorrhea. For most of it, the molecular procedures are meant to mitigate the spread of gonorrhea—Gonococci intricate frequent plans to frustrate the immune system. The illness takes part in extensive stages, and the antigenic disparities resulting from its interference with the body produces surface antigens. The illness is expressed as IgA, which is then attached to the mucus antibodies (Reekie et al., 2018). The infection can mutate into a resistant serum that is an expressed protein subversive agent that hinders the activation of important proteins.

The Evolution of Gonorrhea Pathogen

Gonorrhea has increasingly established resistance to antibiotic medication approved for its treatment. After the dissemination of gonococcal fluoroquinolone resistance, cephalosporin remains to be the most effective drug against gonorrhea (Hill, Masters, & Wachter, 2016). The development of cephalosporin, which effectively fights gonorrhea, would meaningfully obscure the capability of medical experts to medicate gonorrhea successfully since there are limited options for medicating the drug; hence the medics need to come up with an effective manner of ensuring that the mechanism of the issues is termed into medical terms and lead to the important medical process meant to give terms to the medical condition. Also, the successful implication of the changing times for the rapid method of ensuring everything runs smoothly while taking the medication.

Genome Plasticity

 The bacteria Neisseria has perfected horizontal DNA transmission mechanisms and genetic recombination as the main processes of production of broad protein disparity and inflection of genetic countenance (Cornelisse et al., 2019). Localized recombination has been well researched in families with family multi genetic makeup whose alterations support repetitive patterns. Gonococci are fundamentally transformable, and this feature has tremendously enabled the examination of gonorrhea. Gonococci easily combines with DNA filled up with Neisseria sequences. The combination of these genetic material leads to an inverted repetition. Plasmids applied for the transformation of N.gonorrhoeae already is infected with gonorrhea infection hence aiding in replicating the disease all over the body (Jenness et al., 2017). Gonococci are demanding in nature.  They can be grown in areas with multiple nutrients, such as chocolate agar. For the sake of explaining the underlying mechanisms which make gonorrhea resistant to antibiotics. The gonorrhea infection can be transformed into effective bacteria in concentrated agar. This way, one can witness how the infection integrates plasmid into the chromosomal systems, which in turn facilitates mutations (Jones et al., 2019). One single gonococcal DNA can be turned into a circular plasmid, subsequently leading to antibiotic resistance selection and isolation during the crossover. In the end, the study of gonorrhea has led to the identification of more than one medication and DNA format that inhibits the presence of antibiotic medication.

Diagnosis of Gonorrhea

 The diagnosis of basic evaluations of gonorrhea infections led to the emergence of important ways of hindering the disease from spreading further. Besides, an insight into the factual interpretation of how gonorrhea resists antibiotics is an effective way of ensuring that both males and females are treated properly (Kularatne et al., 2018). Urogenital gonorrhea can be detected through urine examination in men or the medical examination of the vagina in women suspected of having a sexually transmitted illness through the application of nucleic acid and other testing mechanisms (Yang et al., 2018). Also, a gonorrhea culture can be used to diagnose gonorrhea through the swab specimens. If two or more people engage in oral or anal sex without protection, a swab can be collected from both parties. With appropriate medication, gonorrhea can be easily cured due to the extensive aspects used to make the disease reduce with time. The patients need to finish the entire medication as instructed to avoid any further apprehension that might arise due to the disease. In the long run, gonorrhea medication differs from one person to another. It is vital to note that even though the gonorrhea medication stops the medication's spread, it cannot reverse the damage done. The resistance the disease exposes the medicine to makes the treatment of the disease harder and more severe. In order to expose the patient to more than one medical option, the medical specialist has to come to terms with the continual expression of the symptoms as they build up with the advancement of or the progression of the infection (Weston et al., 2018). In case the infection persists after completing the infection, a patient is advised to seek medical advice from the medics so that the medication can be reevaluated wholesomely and give way forward to the patient. If symptoms persist further, the patient should return to the medic and seek extensive medication due to the bacteria's replication, causing infection. In case a sexual partner is diagnosed with gonorrhea, they should inform their sexual partners.

 A common technique used in the diagnosis of gonorrhea is the Gram stain technique. The gram technique is specifically used to test males who have symptomatic infections (Shover et al., 2018). The technique uses endocervical specimens to ensure that people can meet all their needs during the medication. In the Gram stain technique, cells with gram-negative gonorrhea bacteria are termed as infected. Some of the places where people take the specification are synovial fluid and within the cervix in females (Tsoumanis, Hens, & Kenyon, 2018). For most of it, the people who are to undertake these tests do not need to wait for long periods of time before getting accurate results from the subjected samples, making these techniques effective for examining symptoms and prescribing medication based on the specified results outcomes. The Gram stain technique can also be used as a substitute mechanism due to the changing patterns associated with gonorrhea infection—the chance of acquiring more than one subjected means of taking care of sampled issues and accurate results.

Gonorrhea Treatment

Gonorrhea can be medicated through appropriate treatment. Most medical research institutes insisted on taking a single dosage of 250mg of intramuscular ceftriaxone (Shover et al., 2018). It is vital to consume all the recommended medication while treating gonorrhea. The medication and some of the most common forms of issuing the disease's personal subjection to more than one causal agent. The medication's exclusive nature depends on how the people are to be presented with the manifestation of the symptoms (Tuite et al., 2017). Therefore, the manifestation of the symptoms dictates the type of treatment one will receive after a long workday. Medical experts can detect gonorrhea in numerous mechanisms. Medics can take samples from symptomatic regions such as the anal and throat areas. The samples are taken with swabs and then take to medical laboratories for further analysis. If a medic suspects that the patient has a blood or joint infection, giving people good and effective results leads to conclusive results.

Discussion

 Gonorrhea is transferred sexually when two people engage in unprotected oral or vaginal sex. Gonorrhea affects body parts such as the urethra, anal region, and throat. In females, gonorrhea affects the cervical and vaginal areas of the body. As stated earlier, the infection spreads through oral, vaginal, or oral intercourse. Whenever infants are infected during birth, the eyes are hindered from effectively working (Oliver et al., 2017). Abstaining from sexual activities or even using latex condoms during sex are among the most common ways of preventing sexually transmitted infections. Also, having one preferred sexual partner effectively prevents gonorrhea from spreading from one sexual partner to another. Moreover, some reports indicated that gonorrhea could fail to indicate symptoms. In these rare cases where patients do not present any symptoms, the medics are forced to rely on pain experienced during urination, pus discharge from the vagina or penis (Arando et al., 2019). In most symptomatic women, gonorrhea is manifested as vaginal discharge, excruciating urination, bleeding during menses, and pelvic pain. Immediately the symptoms start getting out of hand, the handful mechanisms used to hinder the disease from further extending into deeper sections of the body, medics are to subscribe medication based on the needs of the patients (Davis et al., 2018). Neisseria gonorrhoeae is the underlying cause of gonorrhea. Some of the risk factors are associated with the being sexually active because it is an infection that is common among people who are sexually active and below 25 years old. Other factors which might increase susceptibility to the disease. Moreover, untreated gonorrhea can lead infertility among women and sterilization among men due to the inflammatory infection among in the fallopian tubes and even the uterus parts of the reproductive parts. As a result of the complications arising from affected area women find it hard to give birth.

References

Alirol, E., Wi, T. E., Bala, M., Bazzo, M. L., Chen, X. S., Deal, C., ... & Hook, E. W. (2017). Multidrug-resistant gonorrhea: A research and development roadmap to discover new medicines. PLoS medicine, 14(7), e1002366.

Arando, M., Caballero, E., Curran, A., Armengol, P., Barberá, M. J., & Vall-Mayans, M. (2019). The epidemiological and clinical characteristics of the epidemic of syphilis in Barcelona. Actas Dermo-Sifiliográficas (English Edition), 110(10), 841-849.

Choudhri, Y., Miller, J., Sandhu, J., Leon, A., & Aho, J. (2018). Sexually transmitted infections: Gonorrhea in Canada, 2010–2015. Canada Communicable Disease Report, 44(2), 37.

Cornelisse, V. J., Bradshaw, C. S., Chow, E. P., Williamson, D. A., & Fairley, C. K. (2019). Oropharyngeal gonorrhea in absence of urogenital gonorrhea in sexual network of male and female participants, Australia, 2018. Emerging infectious diseases, 25(7), 1373.

Davis, A. P., Stern, J., Tantalo, L., Sahi, S., Holte, S., Dunaway, S., & Marra, C. M. (2018). How well do neurologic symptoms identify individuals with neurosyphilis?. Clinical Infectious Diseases, 66(3), 363-367.

Fairley, C. K., Hocking, J. S., Zhang, L., & Chow, E. P. (2017). Frequent transmission of gonorrhea in men who have sex with men. Emerging infectious diseases, 23(1), 102.

Hill, S. A., Masters, T. L., & Wachter, J. (2016). Gonorrhea-an evolving disease of the new millennium. Microbial cell, 3(9), 371.

Hook III, E. W., & Kirkcaldy, R. D. (2018). A brief history of evolving diagnostics and therapy for gonorrhea: lessons learned. Clinical Infectious Diseases, 67(8), 1294-1299.

Jenness, S. M., Weiss, K. M., Goodreau, S. M., Gift, T., Chesson, H., Hoover, K. W., ... & Rosenberg, E. S. (2017). Incidence of gonorrhea and chlamydia following human immunodeficiency virus preexposure prophylaxis among men who have sex with men: a modeling study. Clinical Infectious Diseases, 65(5), 712-718.

Jones, M. L. J., Chapin-Bardales, J., Bizune, D., Papp, J. R., Phillips, C., Kirkcaldy, R. D., ... & Padgett, P. (2019). Extragenital chlamydia and gonorrhea among community venue–attending men who have sex with men—five cities, United States, 2017. Morbidity and Mortality Weekly Report, 68(14), 321.

Kularatne, R. S., Niit, R., Rowley, J., Kufa-Chakezha, T., Peters, R. P., Taylor, M. M., ... & Korenromp, E. L. (2018). Adult gonorrhea, chlamydia and syphilis prevalence, incidence, treatment and syndromic case reporting in South Africa: Estimates using the Spectrum-STI model, 1990-2017. PLoS One, 13(10), e0205863.

Oliver, S. E., Cope, A. B., Rinsky, J. L., Williams, C., Liu, G., Hawks, S., ... & Ocular Syphilis Disease Investigation Specialists Workgroup Hall Jason Hough Victor Ivey Andre Hawks Stephanie Greene Samantha Taylor Dishonda Mercurio Mike Gipson Miraida. (2017). Increases in ocular syphilis—North Carolina, 2014–2015. Clinical Infectious Diseases, 65(10), 1676-1682.

Reekie, J., Donovan, B., Guy, R., Hocking, J. S., Kaldor, J. M., Mak, D. B., ... & Liu, B. (2018). Risk of pelvic inflammatory disease in relation to chlamydia and gonorrhea testing, repeat testing, and positivity: a population-based cohort study. Clinical Infectious Diseases, 66(3), 437-443.

Shover, C. L., Beymer, M. R., Unger, E. M., Javanbakht, M., & Bolan, R. K. (2018). Accuracy of presumptive gonorrhea treatment for gay, bisexual, and other men who have sex with men: results from a Large Sexual Health Clinic in Los Angeles, California. LGBT health, 5(2), 139-144.

Taylor, S. N., Marrazzo, J., Batteiger, B. E., Hook III, E. W., Seña, A. C., Long, J., ... & Mueller, J. (2018). Single-dose zoliflodacin (ETX0914) for treatment of urogenital gonorrhea. New England Journal of Medicine, 379(19), 1835-1845.

Taylor, S. N., Morris, D. H., Avery, A. K., Workowski, K. A., Batteiger, B. E., Tiffany, C. A., ... & Dumont, E. F. (2018). Gepotidacin for the treatment of uncomplicated urogenital gonorrhea: a phase 2, randomized, dose-ranging, single-oral dose evaluation. Clinical Infectious Diseases, 67(4), 504-512.

Tsoumanis, A., Hens, N., & Kenyon, C. R. (2018). Is screening for chlamydia and gonorrhea in men who have sex with men associated with reduction of the prevalence of these infections? A systematic review of observational studies. Sexually transmitted diseases, 45(9), 615-622.

Tuite, A. R., Gift, T. L., Chesson, H. W., Hsu, K., Salomon, J. A., & Grad, Y. H. (2017). Impact of rapid susceptibility testing and antibiotic selection strategy on the emergence and spread of antibiotic resistance in gonorrhea. The Journal of infectious diseases, 216(9), 1141-1149.

Weston, E. J., Workowski, K., Torrone, E., Weinstock, H., & Stenger, M. R. (2018). Adherence to CDC recommendations for the treatment of uncomplicated gonorrhea—STD Surveillance Network, United States, 2016. Morbidity and Mortality Weekly Report, 67(16), 473.

Yang, L. G., Zhang, X. H., Zhao, P. Z., Chen, Z. Y., Ke, W. J., Ren, X. Q., ... & Tucker, J. D. (2018). Gonorrhea and chlamydia prevalence in different anatomical sites among men who have sex with men: a cross-sectional study in Guangzhou, China. BMC infectious diseases, 18(1), 675.

Diarrheal Disease Epidemiology

 This is the second cause of death among children below 5years old. It can be prevented or medicated. Each year diarrhea claims the lives of more than 525,000 children all over the world.  A noteworthy percentage of diarrhea cases can be avoided by consuming clean water and proper sanitation and cleanliness. Internally, the World Health Organization has reported 1.7billion cases of diarrheal illness each year. In some parts of the world, diarrhea is one of the leading causes of malnutrition in children aged five years and below. In most cases and medical examinations, diarrhea can occur due to more than one factor (Riddle, DuPont, & Connor, 2016). The most common underlying factor responsible for causing diarrhea is contamination found in norovirus or rotavirus. These two viruses most affect children aged 5 years and below. Bacteriological diarrhea normally occurs due to campylobacter or salmonella bacterial organisms. Whenever people live in places with poor hygiene, infections containing Shigella and E.coli tend to lead to diarrhea. Other point s of contact that might cause diarrhea are new foods that the body is not accustomed too, one may experience diarrhea as the body tries its best to get rid of the foreign foods that it is not used to consuming. Also, food intolerances such as gluten can cause one to suffer from diarrhea.  Secondly, irritable bowel syndrome also plays a role in initiating diarrhea because of the high levels of excretion from the body. In addition, whenever the bowels are inflamed, the body might be forced to diarrhea due to the extensive nature with which the body needs to eliminate unwanted waste. Acute diarrhea can last for days or even weeks. Diarrhea that can last for more than 14 days or more is persistent; hence the patient needs to seek further medical counseling from a medical expert.

Descriptive Of the Disease in a Particular Population

 As mentioned earlier, diarrhea most affects children aged 5 years and below. Most of the children come from developing nations, translating the number into 2billion worldwide cases with a 3.2 median for each child. According to investigations done on the disease, females under five years old are more likely to experience diarrhea than their male counterparts. However, some nations claim that boys are more favored than girls, hence accounting for why the girls are more exposed to diarrhea than boys (Vogt, & Finlay, 2017).  The defined microbe responsible for causing diarrhea in communities all over the world is  Enterotoxigenic Escherichia coli. Compared to other microbes, E.coli is accountable for more than half of the cases.

There are three classes of diarrhea- acute moist, acute blood-stained, and persistent. Persistent diarrhea can linger for more than 14 days—diarrhea results from polluted food and water sources. Internationally, 780million people have no access to clean drinking water and proper sanitation hence the spread of diarrhea in developing nations (Acree, & Davis, 2017). In poverty, stricken nations, children aged 3 years old can experience diarrhea three times per year. Each diarrhea episode denies the child a chance to enrich his body with nutrients he deserves to keep the body in the right shape for development.

Diarrhea Distribution by Place

 The hardest hit by this disease are developing countries where poverty is rampant and poor people have no access to clean food material and water sources. In the end, they end up suffering from diarrhea. It is vital to note that diarrhea causes death by dehydrating the body of important nutrients (Cherepaniva et al., 2018). Nutrients that would be otherwise used to build up strength all stead are expelled from the body for good.  The chance to develop mitigation measures only relies on how good people tend to develop proper sanitation mechanisms for cleaning water and food sources. On the other hand, developed countries might experience diarrhea but not in large amounts as developing countries do. The essence of capturing the problem on time can help prevent the disease from further affecting children aged 5 years and below.

Distribution by Time

 As per 2017 medical reports, diarrhea had claimed the lives of more than a 1.6million people all over the world. Diarrheal infections are normally the primary underlying cause of death worldwide. Also, adults aged 70 years and above can be burdened by diarrheal infections. Out of the numerous causes of death, diarrheal infections can be accountable for a tenth of the children's death worldwide (Doan & Malysh, 2017). In 2017, medics developed a vaccine against Rotavirus, the leading microbe responsible for causing diarrhea worldwide.  In every five years, children remain one of the affected age groups internationally. A child who does not receive medical care or has no access to clean food can easily succumb to the disease within a month or less. Most parents are advised to cater to the children's medical needs as far as sanitation and food are concerned. Also, children aged five years and below have weak immune systems compared to other children, hence preventing diarrheal infections from entering into their systems.

References

Acree, M., & Davis, A. M. (2017). Acute diarrheal infections in adults. Jama, 318(10), 957-958.

Cherepaniva, E. A., Goliusov, A. A., Linok, A. V., Filatov, N. N., & Simonova, E. G. (2018). Modern characteristics and tendencies of diarrheal infections epidemic process in Russia. Инфекция и иммунитет, 8(4), 504.

Doan, S. I., & Malysh, N. G. (2017). Epidemiological features of diarrheal infections in Ukraine. Актуальная инфектология, 5(4).

Riddle, M. S., DuPont, H. L., & Connor, B. A. (2016). ACG clinical guideline: diagnosis, treatment, and prevention of acute diarrheal infections in adults. American Journal of Gastroenterology, 111(5), 602-622.

Vogt, S. L., & Finlay, B. B. (2017). Gut microbiota-mediated protection against diarrheal infections—Journal of travel medicine, 24(suppl_1), S39-S43.